Panic and Agoraphobia

Because they are often related, we will consider both Panic and Agoraphobia on the same page.

Panic Disorder

Panic disorder is a problem in which sudden upswings in anxiety symptoms take place, often for no apparent reason. The attacks typically last between 5 and 30 minutes, though their end is often difficult to pinpoint because the person is left with residual anxiety that can last for hours.

The attacks of anxiety consist of a number of physical symptoms, often including (but not limited to) difficulty breathing, heart palpitations, sweating, chills or flushes, tingling or numbness in the extremities, dizziness, choking sensations, and sometimes gastrointestinal symptoms.

Psychological symptoms include intense fear - often of dying, losing control, fainting, or doing something that would be humiliating. A desire to escape to a safe environment is common, hence the development of agoraphobia.

People’s experiences vary, but the first few attacks are usually experienced as being “out of the blue” - seeming to happen in the absence of any external trigger. Over time, people often begin to fear that they will have attacks in particular places, when they are doing particular things, when they are alone, or when they are with people who might judge them negatively. The anticipation of attacks tends to make them more likely, so for many people their attacks seem to become more “triggered” over time (in other words, they tend to happen when the person is in those feared situations). Many people continue to have “untriggered” attacks, however.

Agoraphobia

Literally "fear of the marketplace", agoraphobia is actually a fear of developing extreme physical symptoms in a situation from which escape to a sense of safety might be difficult. The feared symptoms are usually panic attacks, though some people fear other problems (such as losing bladder or bowel control).

Agoraphobia typically begins with avoidance of specific situations in which the symptoms have taken place in the past, or which the person fears could trigger the symptoms.

Avoidance brings relief, which makes the retreat to safety more compelling over time. The list of avoided situations gradually lengthens to a point at which effective functioning is impaired. In extreme cases people have become housebound.

Treatment

Cognitive behavioural treatment of panic and agoraphobia have been found to be remarkably effective.

As with most anxiety disorders, therapy involves an examination of thoughts concerning the symptoms, and gradual supported exposure to anxiety triggers at tolerable intensities. Additional therapy elements are added as needed.

Although they can be extremely disabling, panic disorder and agoraphobia are among the psychological disorders most responsive to treatment.

Note: Information on these pages is provided for educational purposes only. It should not be taken as a substitute for care from a qualified healthcare provider.